Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents

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dc.contributor.author Azar, Riad R.
dc.contributor.author Cote, Gregory A.
dc.contributor.author Kumar, Nitin
dc.contributor.author Ansstas, Michael
dc.contributor.author Edmundowicz, Steven A.
dc.contributor.author Jonnalagadda, Sreenivasa
dc.date.accessioned 2016-06-21T05:46:02Z
dc.date.available 2016-06-21T05:46:02Z
dc.date.copyright 2010 en_US
dc.date.issued 2016-06-21
dc.identifier.issn 0016-5107 en_US
dc.identifier.uri http://hdl.handle.net/10725/4111
dc.description.abstract Background: There are conflicting data on the risk of post-ERCP pancreatitis (PEP) related to self-expandable metallic stents (SEMSs). Objective: To compare rates of PEP in patients who undergo biliary drainage with SEMSs or polyethylene stents (PSs). Design: Retrospective, cohort study. Setting: Tertiary-care medical center. Patients: This study involved patients undergoing ERCP for malignant biliary obstruction between January 2005 and October 2008. Intervention: First-time placement of a SEMS or PS for biliary decompression. Main Outcome Measurements: Early post-ERCP complications, particularly PEP. Results: We identified 544 eligible patients, 248 SEMSs (102 covered), and 296 PSs. The etiology of malignant biliary obstruction was similar between groups, with 55% from pancreatic cancer. The frequency of PEP was significantly higher in the SEMS group (7.3%) versus the PS group (1.3%) (OR 5.7 [95% CI, 1.9-17.1]). On univariate analysis, patient age of 40 years, a history of PEP, and at least 1 pancreatic duct injection were also significant predictors of PEP, whereas female sex and having pancreatic cancer were not. When significant variables were added to a multiple-predictor regression model, the odds of PEP from SEMS placement increased to 6.8 (95% CI, 2.2, 21.4). However, the frequency of PEP was similar between covered (6.9%) and uncovered (7.5%) SEMSs (OR 0.9 [CI, 0.3-2.4]). Purported SEMS-specific risk factors, including the use of cSEMSs, overlapping SEMSs, or having a biliary sphincterotomy were not found to be significant contributors to the higher risk. Limitations: Retrospective design. Conclusion: After we controlled for confounding variables, the frequency of PEP was significantly higher with placement of a SEMS compared with a PS. Rates of PEP were comparable with use of covered and uncovered SEMSs. en_US
dc.language.iso en en_US
dc.title Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 200902767 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Gastrointestinal Endoscopy en_US
dc.journal.volume 72 en_US
dc.journal.issue 4 en_US
dc.article.pages 748-754 en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.gie.2010.05.023 en_US
dc.identifier.ctation Coté, G. A., Kumar, N., Ansstas, M., Edmundowicz, S. A., Jonnalagadda, S., Mullady, D. K., & Azar, R. R. (2010). Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointestinal endoscopy, 72(4), 748-754. en_US
dc.author.email riad.azar@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://www.sciencedirect.com/science/article/pii/S0016510710016834 en_US

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